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General NPI Number Information
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NPI Number | 1548440365
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Entity Type | Organization
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Legal Business Name | WHITE TIGER ENTERPRISES, INC.
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Dates
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Enumeration Date | 11/08/2007
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Last Update Date | 03/19/2008
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Provider Practice Location Address
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Address Line | 302 E 3RD ST
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City | CALEXICO
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State | CA
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Zip | 92231-2760
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Country | US
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Telephone | 760-357-2777
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Fax | 760-357-2111
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Provider Business Mailing Address
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Address Line | 302 E 3RD ST
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City | CALEXICO
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State | CA
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Zip | 92231-2760
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Country | US
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Telephone | 760-357-2777
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Fax | 760-357-2111
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Authorized Official
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Title or Position | MANAGER/SECRETARY
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Name | MR. JOSEPH GELMAN
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Credential | HMDR EXEMPTEE
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Telephone | 760-357-2777
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number | 48116
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License Number State | CA
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